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On 5 April 2022, the United Kingdom reported an increase of cases of severe acute hepatitis of unknown aetiology in children, several needing hospitalisation and some required liver transplant or died. Thereafter, 35 countries reported probable cases, almost half of them in Europe. Facing the alert, on 28 April, Portugal created a multidisciplinary Task Force (TF) for rapid detection of probable cases and response. The experts of the TF came from various disciplines: clinicians, laboratory experts, epidemiologists, public health experts and national and international communication. Moreover, Portugal adopted the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization (WHO) case definition and recommendations. By 31 December 2022, 28 probable cases of severe acute hepatitis of unknown aetiology were reported: 16 male and 17 aged under 2 years. Of these cases, 23 were hospitalised but none required liver transplant or died. Adenovirus was detected from nine of 26 tested cases. No association was observed between adenovirus infection and hospital admission after adjusting for age, sex and region in a binomial regression model. The TF in Portugal may have contributed to increase awareness among clinicians, enabling early detection and prompt management of the outbreak. …

Mortality rates remain substantially elevated after successful treatment of hepatitis C infection in the era of interferon-free antiviral therapy, a study of over 20,000 patients has found. Medscape Medical News…

BackgroundThe burden of chronic hepatitis B virus (HBV) varies across the European Union (EU) and European Economic Area (EEA). AimWe aimed to update the 2017 HBV prevalence estimates in EU/EEA countries and the United Kingdom for 2018 to 2021. MethodsWe undertook a systematic review, adding to HBV prevalence estimates from an existing (2005–2017) database. Databases were searched for original English-language research articles including HBV surface antigen prevalence estimates among the general population, pregnant women, first-time blood donors (FTB), men who have sex with men (MSM), migrants and people in prison. Country experts contributed grey literature data. Risk of bias was assessed using a quality assessment framework. FindingsThe update provided 147 new prevalence estimates across the region (updated total n = 579). Median HBV prevalence in the general population was 0.5% and the highest was 3.8% (Greece). Among FTB, the highest prevalence was 0.8% (Lithuania). Estimates among pregnant women were highest in Romania and Italy (5.1%). Among migrants, the highest estimate was 31.7% (Spain). Relative to 2017 estimates, median prevalence among pregnant women decreased by 0.5% (to 0.3%) and increased by 0.9% (to 5.8%) among migrants. Among MSM, the highest estimate was 3.4% (Croatia). Prevalence among people in prison was highest in Greece (8.3%) and the median prevalence increased by 0.6% (to 2.1%). ConclusionsThe HBV prevalence is low in the general population and confined to risk populations in most European countries with some exceptions. Screening and treatment should be targeted to people in prison and migrants. …

BackgroundGeorgia has adopted the World Health Organization European Region’s and global goals to eliminate viral hepatitis. A nationwide serosurvey among adults in 2015 showed 2.9% prevalence for hepatitis B virus (HBV) surface antigen (HBsAg) and 25.9% for antibodies against HBV core antigen (anti-HBc). HBV infection prevalence among children had previously not been assessed. AimWe aimed to assess HBV infection prevalence among children and update estimates for adults in Georgia. MethodsThis nationwide cross-sectional serosurvey conducted in 2021 among persons aged ≥ 5 years used multi-stage stratified cluster design. Participants aged 5–20 years were eligible for hepatitis B vaccination as infants. Blood samples were tested for anti-HBc and, if positive, for HBsAg. Weighted proportions and 95% confidence intervals (CI) were calculated for both markers. ResultsAmong 5–17 year-olds (n = 1,473), 0.03% (95% CI: 0–0.19) were HBsAg-positive and 0.7% (95% CI: 0.3–1.6) were anti-HBc-positive. Among adults (n = 7,237), 2.7% (95% CI: 2.3–3.4) were HBsAg-positive and 21.7% (95% CI: 20.4–23.2) anti-HBc-positive; HBsAg prevalence was lowest (0.2%; 95% CI: 0.0–1.5) among 18–23-year-olds and highest (8.6%; 95% CI: 6.1–12.1) among 35–39-year-olds. ConclusionsHepatitis B vaccination in Georgia had remarkable impact. In 2021, HBsAg prevalence among children was well below the 0.5% hepatitis B control target of the European Region and met the ≤ 0.1% HBsAg seroprevalence target for elimination of mother-to-child transmission of HBV. Chronic HBV infection remains a problem among adults born before vaccine introduction. Screening, treatment and preventive interventions among adults, and sustained high immunisation coverage among children, can help eliminate hepatitis B in Georgia by 2030. …

BackgroundBetween May 2015 and February 2022, 77,168 hepatitis C virus (HCV)-infected people in Georgia have been treated through an HCV elimination programme. To project the programme’s long-term impacts, an HCV infection model was initially developed, based on data from surveys among people who inject drugs and a national serosurvey in 2015. AimAccounting for follow-up surveys in 2021, we validate and update projections of HCV infection prevalence and incidence. MethodWe assessed the initial model projections’ accuracy for overall prevalence, by age, sex, and among people who ever injected drugs, compared with 2021 serosurvey data. We used 2021 results to weight model fits and to recalculate the national programme’s impact leading up to March 2022 on HCV infection incidence rates. Cases and deaths averted were estimated. The impact of reduced treatment rates during the COVID-19 pandemic was assessed. ResultsThe original model overpredicted adult (≥ 18 years old) chronic HCV infection prevalence for 2021 (2.7%; 95% credible interval (CrI): 1.9–3.5%) compared with a 2021 serosurvey (1.8%; 95% confidence interval (CI): 1.3–2.4%). Weighted model projections estimated a 60% decrease in HCV infection incidence by March 2022, with an absolute incidence of 66 (95% CrI: 34–131) per 100,000 person-years (overall population). Between May 2015 and March 2022, 9,186 (95% CrI: 5,396–16,720) infections and 842 (95% CrI: 489–1,324) deaths were averted. The COVID-19 pandemic resulted in 13,344 (95% CrI: 13,236–13,437) fewer treatments and 438 (95% CrI: 223-744) fewer averted infections by March 2022. ConclusionResults support the programme’s high effectiveness. At current treatment rate (406/month), 90% reductions in prevalence and incidence in Georgia are achievable by 2030. …

Managing alcohol-associated hepatitis following hospital discharge requires treating not only the liver disease but also the underlying alcohol use disorder, says a clinical care review. Medscape Medical News…

This report describes progress towards hepatitis B control and elimination in the World Health Organization African region.

World Hepatitis Day is an opportunity to remind people of the impact of viral hepatitis and to offer information that can help prevent, diagnose, and treat these diseases, said one expert. Medscape Medical News…

This report describes new CDC guidance for completing hepatitis C virus testing.

Patients with hepatitis C virus (HCV) infection face barriers at every step, from diagnosis to accessing breakthrough direct-acting antiviral (DAA) medications, experts say. Medscape Medical News…

Bulevirtide, an investigational, first-in-class hepatitis delta virus entry-inhibitor, significantly reduced viral load and normalized liver enzymes in patients. Medscape Medical News…

This report describes progress towards achieving hepatitis C viral clearance by 2030.

Vaccination rates for hepatitis B virus are slightly lower among patients with psoriasis than among people without psoriasis. Medscape Medical News…

Echovirus 11 (E11) has recently been associated with a series of nine neonatal cases of severe hepatitis in France. Here, we present severe hepatitis caused by E11 in a pair of twins. In one of the neonates, the clinical picture evolved to fulminant hepatitis. The E11 genome showed 99% nucleotide identity with E11 strains reported in the cases in France. Rapid genome characterisation using next generation sequencing is essential to identify new and more pathogenetic variants. …

This report describes the effectiveness of the Cherokee Nation Health Services hepatitis C elimination program after 5 years.

Hepatitis A -- United StatesOnce again, cases of hepatitis A in San Diego County are on the rise with 28 reported to date and 18 among people experiencing homelessness. The county usually reports about 2 virus cases monthly. While no single outbreak location has been identified, and no specific food or water source found, cases are being reported above baseline.The county is doing its part to take steps to prevent more spread of the disease. The current increase in cases is likely due to person-to-person transmission…

Hepatitis A -- CanadaVancouver Coastal Health is notifying people who dined at McDonald\'s (3695 Lougheed Hwy, Vancouver) about a possible exposure to hepatitis A on the following dates and times:19 Apr 2023 - 8am to 4pm21 Apr 2023 - 12pm - 7:30pm23 Apr 2023 - 8am - 4pm26 Apr 2023 - 8am - 4pm27 Apr 2023 - 7am - 2pm28 Apr 2023 - 7am - 3pm29 Apr 2023 - 7am - 3pm30 Apr 2023 - 8am - 4pm2 May 2023 - 7am - 3pm4 May 2023 - 8am - 4pm8 May 2023 - 6am - 11am9 May 2023 - 6am - 9amAlthough the…

Hepatitis E -- ChinaHong Kong health officials report investigating a case of human infection of rat Hepatitis E virus (HEV). The case involves a 32-year-old man with underlying illnesses. He was found to have an abnormal liver function during his follow-up in Queen Elizabeth Hospital. The patient is now in stable condition. His blood sample tested positive for rat HEV upon laboratory testing. Epidemiological investigations revealed that the patient resides in Wong Tai Sin. He did not have contact with rodents or…

Hepatitis A -- CanadaHalton Region Public Health has confirmed a case of hepatitis A at a Milton golf club after a food handler at its restaurant tested positive.The agency says the person worked at RattleSnake Point Golf Club Bistro between 20 Apr 2023 and 2 May 2023. The golf club is working closely with the public health agency to contact affected visitors.Hepatitis A is an infectious disease caused by a virus that attacks the liver. According to the agency, symptoms usually happen within 28 to 30 days…

BackgroundEuropean Union/European Economic Area (EU/EEA) countries annually report hepatitis A (HepA) notifications to The European Surveillance System (TESSy). AimTo describe EU/EEA HepA notifications from 2010 to 2019 and identify infection drivers and surveillance improvements. MethodsWe analysed demographic, clinical and transmission information of HepA confirmed cases from TESSy. We stratified countries by population susceptibility profile and performed time-series analysis to describe trends in notification rates, sex distribution and travel history. ResultsTwenty-nine EU/EEA countries reported 139,793 HepA cases. Six eastern EU countries reported > 60% of these cases. EU/EEA notification rate during the study period was 3.2 cases per 100,000 population (range 2.7–5.6). Notifications peaked in 2014 and 2017, with marked differences in case demographic characteristics. Notification trends varied across different country susceptibility groups. In 2017, the proportion of males (74%) and case median age (31 years) increased steeply, while no changes occurred in 2014. Travel history showed seasonal case peaks following the summer. More than 47,000 hospitalisations were reported. Annual case fatality was

Hepatitis A -- United StatesAt a glance-----------Reported cases: 9States: 3Hospitalizations: 3Deaths: 0CDC, state public health and regulatory officials, and the Food and Drug Administration (FDA) are investigating an outbreak of hepatitis A linked to frozen organic strawberries imported from certain farms located in Baja California, Mexico by a common supplier. Frozen organic strawberries may be sold to a variety of retailers under multiple brand labels. Traceback and epidemiological investigations show…

Hepatitis E -- South SudanSituation at a glance---------------------On 14 Apr 2023, the Ministry of Health (MoH) of South Sudan declared an outbreak of the hepatitis E Virus (HEV) in Wau city, the capital of Western Bahr el-Ghazal state and one of the largest cities in South Sudan. Between 23 Mar 2023 and 13 Apr 2023, a total of 91 HEV suspected cases have been reported from Wau, of which 35 are confirmed; there have been 5 deaths reported (case fatality ratio [CFR] 5.5%). A multidisciplinary national rapid…

Hepatitis A -- AustraliaVictorians who dined at a cafe in Melbourne\'s southeast have been warned to watch for hepatitis A symptoms after 2 cases linked to the venue were reported. The 2 cases of hepatitis A have been linked to the Creatures of Habit cafe, which is located in the Springvale Homemaker Centre. Anyone who consumed food at the cafe between 25 Mar 2023 and 8 Apr 2023 should monitor for symptoms and seek medical attention if they appear. The cafe has undergone extensive cleaning and is no longer a risk. No…

Hepatitis A -- United StatesAccording to the Pennsylvania Department of Health (DOH), in 2023, 46 confirmed hepatitis A cases were reported in Pennsylvania as of 8 Apr 2023, with 44 reported in the southeast region. This includes a preliminary count of 23 confirmed, locally acquired hepatitis A virus (HAV) cases in Philadelphia since January 2023. Among the HAV cases occurring since January 2023, 15 cases (65%) reported current injection and/or non-injection drug use including 8 cases (35%) who were also experiencing…

Hepatitis -- IndiaFollowing the death of at least 7 people in 2 weeks at Amingaon in North Guwahati due to a hepatitis A outbreak in the area, Assam Chief Minister Himanta Biswa Sarma visited the spot and reviewed the water quality in the area along with officials from the Railways and PHED (Public Health Engineering Department). The chief minister directed the concerned officials to deploy a medical team from Gauhati Medical College and Hospital (GMCH) at Amingaon and neighboring areas to conduct a thorough…

Hepatitis E -- South SudanSouth Sudan on Tuesday [18 Apr 2023] reported 5 deaths and 91 suspected cases from an outbreak of hepatitis E in the northwest of the country. The cases were reported in Wau city, which is the capital of western Bahr el Ghazal State. Health Minister Yolanda Awel Deng urged the public to remain calm. Deng urged citizens to observe all precautionary measures, including washing their hands with soap, using latrines and maintaining a clean environment.Hepatitis E is a liver infection caused by…

A test for HIV, hepatitis B, and hepatitis C that uses a single dried blood spot could increase testing for these viruses in high-risk and challenging settings, new data show. Medscape Medical News…

Hepatitis A -- United StatesFederal officials have confirmed that the strain of hepatitis A virus found in frozen organic strawberries involved in a multi-state outbreak in 2023 is the same strain that caused an outbreak in 2022. The organic strawberries associated with both outbreaks were imported to the United States from the same growing area in Baja California, Mexico, according to an outbreak update from the Food and Drug Administration (FDA).So far in 2023 there have been 7 people confirmed infected, and all 7…

When researchers compared patients who met treatment criteria, treatment initiation was similar across races and socioeconomic status. But that finding raises other questions. Medscape Medical News…

De nyeste tal fra Statens Serum Institut viser, at der ikke blev fundet nogen hiv-positive bloddonorer i bloddonorscreeningen i 2019 og kun ganske få tilfælde af hepatitis B og C.

I 2015 modtog Statens Serum Institut 13 anmeldelser af tilfælde af akut, og 312 tilfælde af kronisk hepatitis C. Dette antal er på linje med de seneste år.

I 2014 modtog Statens Serum Institut syv anmeldelser af tilfælde af akut, og 235 tilfælde af kronisk hepatitis C. Dette antal er på linje med de seneste år.

This report describes the spread of hepatitis A following an outbreak in Virginia.

An investigation into the cause behind the sometimes-life-threatening liver inflammation in children points to simultaneous infection with common childhood viruses. Medscape Medical News…

Hepatitis -- United KingdomAbstract--------An outbreak of acute hepatitis of unknown etiology in children was reported in Scotland in April 2022 and has now been identified in 35 countries. Several recent studies have suggested an association with human adenovirus (HAdV), a virus not commonly associated with hepatitis. Here we report a detailed case-control investigation and find an association between adeno-associated virus 2 (AAV2) infection and host genetics in disease susceptibility. Using next-generation…

Hepatitis A -- United StatesAt a glance-----------Reported cases: 5States: 1Hospitalizations: 2Deaths: 0Investigation details---------------------CDC, state public health and regulatory officials, and the FDA are investigating an outbreak of hepatitis A linked to frozen organic strawberries imported from certain farms located in Baja California, Mexico, by a common supplier. Frozen organic strawberries may be sold to a variety of retailers under multiple brand labels. Traceback and epidemiological…

The previous risk-based testing approach was not successful at detecting most people living with chronic hepatitis B infection, the agency said. Medscape Medical News…

Hepatitis -- France[The abstract, case report, and discussion are shown here. The rest of this publication, including references, can be found at the original URL. - Mod.LL]Abstract--------In March 2022, a 61-year-old woman in France who had received a heart-lung transplant sought treatment with chronic hepatitis mainly characterized by increased liver enzymes. After ruling out common etiologies, we used metagenomic next-generation sequencing to analyze a liver biopsy sample and identified an unknown…

Hepatitis -- United StatesThe US National Center for Immunization and Respiratory Diseases today [15 Feb 2023] reported that 5 additional children with acute hepatitis of unknown etiology were reported over the past month.Investigators are examining a possible relationship to adenovirus type 41 infection, which is not a common cause of hepatitis in otherwise healthy children. 'While rare, children can still have serious hepatitis, and we don't always know the cause. That's why investigators continue to look at…

Hepatitis A -- IndiaHepatitis A has broken out at Wathu village in Shopian district; 5 persons have tested positive. Samples of 150 persons have been also taken for the testing. This is not for the 1st time in recent times that hepatitis A has broken out in any South Kashmir village. According to reports, earlier some cases were reported from Ganowpora area in the same district. Few months back, 2 children had died due to hepatitis A at Turka Tachloo village in south Kashmir. The medical experts have been saying…

Hepatitis A -- United StatesSan Diego County is monitoring an increase in hepatitis A cases, with 5 recent confirmed cases and a death, health officials said Tuesday [14 Feb 2023]. All the confirmed cases saw the onset of illness between 10 Jan 2023 and 6 Feb 2023, according to the San Diego County Health and Human Services Agency (HHSA). Three of the cases were among people experiencing homelessness, including the person who died. According to the HHSA, there are 'no known direct contacts and the 5 cases do not meet the…

BackgroundThe World Health Organization European Action Plan 2020 targets for the elimination of viral hepatitis are that > 75% of eligible individuals with chronic hepatitis B (HBV) or hepatitis C (HCV) are treated, of whom > 90% achieve viral suppression.AimTo report the results from a pilot sentinel surveillance to monitor chronic HBV and HCV treatment uptake and outcomes in 2019.MethodsWe undertook retrospective enhanced data collection on patients with a confirmed chronic HBV or HCV infection presenting at one of seven clinics in three countries (Croatia, Romania and Spain) for the first time between 1 January 2019 and 30 June 2019. Clinical records were reviewed from date of first attendance to 31 December 2019 and data on sociodemographics, clinical history, laboratory results, treatment and treatment outcomes were collected. Treatment eligibility, uptake and case outcome were assessed.ResultsOf 229 individuals with chronic HBV infection, treatment status was reported for 203 (89%). Of the 80 individuals reported as eligible for treatment, 51% (41/80) were treated of whom 89% (33/37) had achieved viral suppression. Of 240 individuals with chronic HCV infection, treatment status was reported for 231 (96%). Of 231 eligible individuals, 77% (179/231) were treated, the majority of whom had received direct acting antivirals (99%, 174/176) and had achieved sustained virological response (98%, 165/169).ConclusionTreatment targets for global elimination were missed for HBV but not for HCV. A wider European implementation of sentinel surveillance with a representative sample of sites could help monitor progress towards achieving hepatitis control targets.…

Hepatitis A -- United KingdomAn outbreak of Hepatitis A has been reported at an Ipswich primary school, sparking concern among worried parents wondering what precautions will be taken.Hepatitis A is a contagious liver infection that, though commonly does not cause any long-term problems, can be life-threatening if it leads to liver failure. A letter from the UK Health Security Agency was sent to parents of children at The Willows Primary School on [Sat 21 Jan 2023].A consultant in health protection stated: 'We…

Q Fever -- Bosnia and HerzegovinaThe veterinary inspection inspectorate of the cantonal administration for inspection affairs of the canton of Sarajevo received a report on examination of organ samples from calves of the veterinary faculty of the University of Sarajevo, in which in one case of the presence of the gene, the causative agent of Q fever, was determined by the PCR method.According to the information, the examination of the sample...was carried out as part of the routine differential diagnosis of hepatitis in…

This report describes 2021 data from National Center for Health Interview Survey on the percentage of adults who have ever had hepatitis by age group and sex.

Direct-acting antiviral therapy significantly improves liver outcomes, nonliver outcomes, and long-term survival for patients with chronic hepatitis C virus, regardless of disease stage. Medscape Medical News…

Antallet af tilfælde med akut hepatitis B er fortsat lavt i Danmark. Kronisk hepatitis B er faldende.

BackgroundAccording to the World Health Organization, hepatitis C virus (HCV) infection should be under control by 2030.AimOur aim was to describe the size and temporal changes in reported cases of chronic HCV infection in Denmark and Sweden and to estimate the size of the hidden (undiagnosed) population born before 1965.MethodsWe extracted all HCV infections reported to national surveillance systems in Denmark and Sweden from 1990 to 2020. Prediction of the size of the hidden HCV-infected population was restricted to the cohort born before 1965 and cases reported up to 2017. We applied a model based on removal sampling from binomial distributions, estimated the yearly probability of diagnosis, and deducted the original HCV-infected population size.ResultsDenmark (clinician-based) reported 10 times fewer hepatitis C cases annually than Sweden (laboratory and clinician-based), peaking in 2007 (n = 425) and 1992 (n = 4,537), respectively. In Denmark, the birth year distribution was monophasic with little change over time. In recent years, Sweden has had a bimodal birth year distribution, suggesting ongoing infection in the young population. In 2017, the total HCV-infected population born before 1965 was estimated at 10,737 living persons (95% confidence interval (CI): 9,744–11,806), including 5,054 undiagnosed, in Denmark and 16,124 (95% CI: 13,639–18,978), including 10,580 undiagnosed, in Sweden.ConclusionsThe reporting of HCV cases in Denmark and Sweden was different. For Denmark, the estimated hidden population was larger than the current national estimate, whereas in Sweden the estimate was in line with the latest published numbers.…

Hepatitis A -- IndiaA total of 6 cases of hepatitis A have been reported in Turka Tachloo village of South Kashmir's Anantnag district. A top official said that the cases have been reported in the village, 2 have died and 4 are under observation. He said Turka Tachloo is part of the Anantnag district, however, it falls under the jurisdiction of Kulgam in terms of Health and Jal Shakti blocks. He added both district magistrates of Kulgam and Anantnag are monitoring the situation in the village.CMO Kulgam, Dr.

This issue of the ECDC Communicable Disease Threats Report (CDTR) covers the period 4 – 10 December 2022 and includes updates on COVID-19, Ebola virus, respiratory syncytial virus, streptococcal infection, diphtheria, seasonal influenza, mpox (monkeypox), hepatitis, MERS-CoV, meningitis, and mass gathering monitoring at the FIFA World Cup 2022 Qatar.